Welcome to Memory Care Support’s 
May 2016 newsletter!

Caring for Those Affected by Dementia Is the Greatest Challenge Facing Assisted Living

Care for those affected by dementia is the greatest challenge facing Assisted Living in the coming years.  The Senior Housing industry is only seeing the tip of the iceberg with the wave of elders coming their way.  If a person with dementia is unable to live at home, surveys show that their location of choice will be a Memory Care neighborhood in a nearby Assisted Living Community.  And the likelihood is that the person will also be quite elderly (the majority of residents living in AL are older than 85 years old) and have several chronic health conditions in additional to their dementia!   

Leaders in Assisted Living are realizing that providing life-affirming, dignified care to their residents affected by dementia is very complicated.  It’s not enough to have a Memory Care neighborhood with a secure front door and comfortable environment.  State regulators and consumers are looking with renewed attention at how services are delivered to those residents affected by memory changes.  The field of Memory Care is rapidly evolving and changing.  I feel that most of what we’ve learned about providing Memory Care, we’ve learned in the last few years.  And as we look ahead five or ten years, we will probably look back on what we are delivering today and say, “Wow! We’ve really changed, we are so much better!”   

I work with many Assisted Living operators who are either beginning their journey to develop a Memory Care Neighborhood or want to assess and refresh their Memory Care program.   

There are three primary areas to develop in order to provide optimal care for residents affected by dementia: 

Culture - is it really person-centered?  How do you create an environment where the resident with dementia is at the center, allowed to express preferences and make choices?  Is it easier for the care team to “do for” rather than support and collaborate?  And is there still focus on deficits, such as references to what the resident “used to be…” i.e., a teacher, an accountant, a lawyer rather than “she is an excellent reader, he assists us in repairing our plumbing, she leads us in exercise every morning.”  We know that how residents are perceived by the care team greatly affects how care is delivered.  If residents are valued, care will be better. 

Engagements – many Assisted Living communities are changing the idea that they have to post the monthly “Activity Calendar” in a prominent place on their wall.  Entertainment can definitely be a fun event, but on a daily basis, it is meaningful engagements which will be significant for the residents with memory changes.    Passive entertainment, whether watching TV or an entertainer, can’t add purpose and self-confidence to a resident’s life.

I recently witnessed a great engagement program at a Memory Care neighborhood in an Assisted Living I toured.   It was the first week in April and they were getting ready for Cinco de Mayo celebration in a few weeks.   The neighborhood had about 40 residents living there and as I entered the large common area, I saw three different groups sitting around tables.  One group was learning Spanish words so they could meet and welcome visitors who would be coming to their Cinco de Mayo party.  The group was led by a CNA who was from Mexico and there was much laughter as the residents tried to pronounce the words on the flash cards she held up.  The second table had a group of residents who were discussing their favorite foods from Mexico.  They were preparing a mild salsa to sample with chips and looking at cookbooks with other Mexican recipes.  And the third table had a giant map of Mexico on the wall and a CNA from Mexico was talking about her home town.  Other residents were remembering their vacation trips to various regions in Mexico. 

These residents were enjoying their social time together, learning new words, and trying tempting flavors – the only thing missing was the Margaritas and I was assured they would have a Margarita machine at the Cinco de Mayo party.  Good for them! 

Health and Wellness – since so many elderly people affected by dementia also have multiple chronic illnesses, it is difficult to provide a life-affirming and safe environment without regular nursing oversight.  Dementia can mask other illnesses and increase the severity, resulting in more frequent and lengthier hospitalizations.  Many Assisted Living owners are working to develop effective systems to collect clinical data and improve response time to changes in residents’ health status.   

And a comprehensive Wellness program which incorporates exercise, good diet, stress management, balance/gait improvement, and cognitive stimulation can greatly add to the quality of the residents’ lives.   Engagements, such as dog walking, gardening, yoga and dancing, can be planned to entice the residents to be up out of their chairs and mobile. 

Health and Wellness also extends throughout the life continuum to support for end-of-life care.  For the communities that allow aging-in-place, embracing end-of-life care makes good sense.  Let’s initiate conversations, learn preferences, anticipate the residents’ and families’ needs and provide a dignified and compassionate end-of-life experience.  

It is gratifying to see so many Assisted Living operators asking questions and examining ways to  better deliver life-affirming, dignified care to their residents affected by dementia. 

Have a great day! 

If you work in LTC/Assisted Living and want
To make your dementia care program even better,
Or if you need assistance in
Planning care for a loved one,
E-mail or call me for a free consultation.

Anne Ellett, N.P., M.S.N.
AANC Certified Gerontological Nurse
Founder, Executive Director - Memory Care Support
Ph. 949 933-6201

Anne Ellett

Dementia Care Specialist AANC Certified Gerontological Nurse
Founder, Executive Director

Memory Care Support
People Are Watching...

Many of us watched the HBO documentaries produced in 2009 as part of their ALZHEIMER’S PROJECT.   In collaboration with the NIA, four documentaries were made.  One of the films features scientists working on research, and the other three films highlight very personal stories, giving us insight into the effect of dementia on those diagnosed as well as their family members.   
All of the films are excellent quality.  Sometimes we can feel overloaded with all the daily news from the media about Alzheimer’s and other dementias.  However, these HBO films, particularly the three about personal stories, are especially worth watching, even if you’ve seen them previously.  If you’re a family member, it can help you understand what people are experiencing.  And if you work in the profession of providing care for people affected by dementia, these films are reminders of the difference you can make in the lives of these people.  These films are available free through the HBO website – they would be great to watch to stimulate family discussions or for training of staff. 

With studies showing that at least 54% of families in the U.S. are touched by some form of dementia, it is so essential that all of us learn as much as we can about the condition.   
How Many Pills Are You Taking?

I just returned from presenting at the ACHCA conference in Philadelphia on Optimal Dementia Care.  I always address the common problem of over-medicating our elderly.  In our fragmented health care system, prescriptions get layered on and many elders are taking 10-20+ prescription pills/day plus additional non-prescription supplements!  Many people living with dementia cannot tell us when they are experiencing adverse effects of medications,  As medications get added on, seldom is something taken away – Remember,  Less is more!.  If you are caring for someone with dementia, review their medications and supplements and consider what can be eliminated.
7 Essentials of Good Care:
We all deserve GOOD CARE. Whether you or your loved one affected by dementia are receiving care in a private home or an assisted living community, there are seven essential elements that I believe are crucial for providing good quality of life.

Essential #1 Dignity
Essential #2 Loving and Compassionate Relationships
Essential #3 Stimulating and Age-Appropriate Activities
Essential #4 Choices
Essential #5 Safety
Essential #6 Attentive Medical Care
Essential #7 End of Life Planning and Support

You can read more information here about these 7 Essentials.
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